Statewide project aims to improve care for heart-attack patients

GREENVILLE, N.C.   —   Doctors, nurses and other heart-attack experts will discuss eastern North Carolina’s participation in a statewide project aimed at improving cardiac care during a press conference Tuesday, Feb. 7 at Pitt County Memorial Hospital in Greenville.

The press conference will be at 10 a.m. in Medical Staff Conference Room D. Reporters should park in the Support Building parking lot between the EastCare helipad and the Cardiovascular Center. The conference room is in the Support Building.

Babb

With organization and support from PCMH, cardiologists and emergency physicians at the Brody School of Medicine at East Carolina University, local private-practice cardiologists, and doctors and hospitals across eastern North Carolina are working together to improve the survival rate of patients rushed to hospitals with heart attacks. They are part of a larger statewide consortium of North Carolina health care providers and Blue Cross and Blue Shield of North Carolina. The consortium calls its project RACE, short for Reperfusion of Acute M.I. in Carolina Emergency departments.

“We know from multiple sources that patients in North Carolina are not getting potentially life saving therapy often enough or soon enough,” said Dr. Joseph Babb, a professor and cardiologist at the Brody School of Medicine and director of the cardiac catheterization laboratories at PCMH. With the knowledge and practice gained in the RACE project, he added, “(p)atients will benefit by receiving appropriate therapy more rapidly and, if hospital transfer is needed as part of that therapy, realizing said transfer in a more expedited fashion.”

The issue is especially important in North Carolina, RACE team members said, since national registries have shown that only about 60 percent of North Carolinians who come to an emergency room with symptoms of a myocardial infarction, or heart attack, receive potentially life-saving reperfusion therapies to open their clogged arteries, compared to the national average of at least 70 percent. National benchmarks are for patients to receive drugs within a half-hour and angioplasty, if needed, within 90 minutes. Angioplasty is the use of a balloon that’s threaded through the arteries to the blockage and then inflated to reopen the artery, restore blood flow and spare damage to heart muscle due to a lack of oxygen.

If successful, RACE could also serve as a national model for collaborative efforts to improve the delivery of emergency care.

The 29-county region of North Carolina PCMH and ECU serve has an age-adjusted rate of coronary heart disease death rate of 185.8 for every 100,000 people. If the region were a state, that rate would rank it 13th worst in the country, according to ECU’s Center for Health Services Research and Development. Coronary heart disease includes heart attack.

The RACE consortium comprises five regions centered in Greenville, Durham/Chapel Hill/Greensboro, Winston-Salem, Charlotte and Asheville. Other partners in the project include the Duke Clinical Research Institute of Duke University Medical Center and the North Carolina chapter of the American College of Cardiology. Blue Cross Blue Shield of North Carolina is supporting the project with a $1 million grant, which helps pay salaries of project coordinators and for data collection and analysis.

Throughout the two-year project, RACE researchers will collect data on heart attack patients who receive treatment as well as those who would have been candidates for reperfusion therapy but did not receive it. The goal is to streamline patient evaluation and treatment. Reperfusion therapies involve using either a clot-dissolving drug or angioplasty. While clot-dissolving, or thrombolytic, drugs are available at most hospitals and emergency rooms, angioplasty is not as widely available. Angioplasty has become the preferred therapy for opening blocked coronary arteries and is most effective.